NPI | 1558410498 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA G45737) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA G45737) |
Enumeration Date | 2007-01-09 |
Last Update Date | 2024-04-27 |